NHS Dentistry No Longer Available For Children

albertross_2

Toothsmith (or anyone in the profession),

Could you explain the NHS rules or (is it a purely financial decision) behind patients being thrown off the dentists register if they aren't able to keep having their regular NHS checkup?

Is each practice limited to the number of patients they can have by the NHS, and therefore loses ££ if someone can't turn up for a regular checkup.

Sorry to OP..

Toothsmith

The registration period is 15 months. This is the amount of time your 'contract' with your NHS dentist lasts. That period is set by government.

If it goes more than 15 months between visits, or if it's more than 15 months since your dentist last sent off a completed form for you (You may have gone in, but not returned to finish off treatment, therefore yuor previous completed treatment would count as the date) you fall off the dentist's register.

There is nothing to stop a dentist re-signing you, but the truth is that NHS dentists are so busy that this mechanism acts like a 'natural selection' process.

Also, if a dentist does re-sign you, he has obligations to you in terms of providing out-of-hours cover and emergency appointments. The patients that tend to need these inconvienient appointments, by and large, are the ones who do not attend regularly.

BFG_2

Fraserca wrote:

The situation has been allowed to develop where high charges prevent people ( and not just poor people ) from attending the dentist until it is too late.

I genuinely laughed out loud when I read this (no offence intended).

Many people believe that the money they pay is 'the dentist's pay' ie salary to take home - wrong (see below)

Would you say that £9 was a 'high charge' for amputating part of a persons finger?? Coz that's what a tooth extraction is?

BTW out of the £9 the dentist has to pay for
1. staff - one nurse and 0.5 support staff - maybe we could use illegal immigrants to keep the 'high charges' down??
2. MAterials - maybe we could use BluTak instead of filling material??
3. Building purchase/lease - maybe we could do it in a caravan/shed
4. ALL other running costs - maybe we could use our X-ray vision rather than buy and run a £15,000 X-ray machine
5. Sterilisation and cleaning up costs and time - or maybe it would be cheaper if dentists didn't sterilise in between the AIDS/HIV patient and your lovely little Johnie

I could go on, but it would only depress me.

If you genuinely believe that dental charges are high, consider the following: NHS dentistry is THEE most cost effective delivery mechanism for healthcare within the NHS (indeed within the civilised world). Now knowing that, isn't it interesting (and frightening) to think how expensive the other bits of the NHS must be!!!!!!

Davidboy

Toothsmith wrote:

You mean barbers!

Anyway, just for the sake of comparison, how much do you think a hairdresser would charge to pull out a tooth?

More than to pierce someone's ears? More than a cut & blow dry? More or less than to tint someones hair?

At the place I go, a tinting is £45, piercing ears is £25

The former is close to my private tooth extraction price, the latter is still double the NHS fee for an extraction.

Makes you think doesn't it?

Toothy mate was only joking!!

It is just a fact that very shortly, how are any of us going to live? They are now expecting us all to work to 70, hence my workhouse jibe, with the cost of gas and leccy is now going higher and higher, petrol all time high. I am still fortunate that my dentist is still NHS, (not heard anything so assume he is!!), to get anything done you need to go private. Yet my pay aint moved for quite a while, so in business terms I have taken a pay cut for a few years. Where does it all end, how do we carry on and still survive with a half decent life. It all looks very gloomy. No one is saying that dentists are not worth their money, tooth ache is the worst. But my work mate was quoted £1000 for a crown, this is not right. Toothsmith can state the dentist point all he likes, but NHS dentists are now a rarity and to pay these astronomical private costs is just not fair when I like many others pay a fortune in NI contributions but get nothing in return. Yes I know it is like an insurance, hospitals there when you need them, but things have to change...don't they? Or do we are move to poverty and can afford nothing.

And yes I did mean barbers. Oops slip of the keys!


D

Toothsmith

£1000 for a crown is very top end. This is either a very up-market cosmetic practice, or your friend was not giving you the full story.

If the tooth was badly broken down, needed root filling, and re building prior to crowning, then £1000 is possibly the TOTAL bill. But that is a heck of a lot more work than just crowning a tooth.

It's a bit like saying a builder is going to charge me £100,000 to put a chimney on my roof without bothering to inform you that he has to build a house to put the chimney on in the first place!

I'm sure he would have been given alternatives. If a tooth needs that much work to 'crown' then having it out and replaced by a bridge is a realistic, and possibly cheaper alternative.

I appreciate that private dentistry is expensive, but that's how much it costs to run the service. I would love to provide a low cost service, but it ISN'T a low cost thing, so someone would have to subsidise it.

If the Government want to step in there and then call it NHS dentistry, that's fine by me, but they need to get their act together and produce a package that is workable. What we have at the moment is crumbling, and the thing that's going to replace it come April is so bad it's dead in the water already.

I'm not getting at you DavidBoy. Your concerns are valid, and your opinions are a lot more sensible then some I've had to deal with on these pages.

The bottom line though is that dentistry is a bespoke service. No two mouths, people or fillings are exactly the same, therefore there can be no 'mass market discount' for it.

Dental practices have to stand up as a business in this country, which means they have to have an income in excess of expenditure.

Rikki

I have just spent an hour and half with my dentist having my bridge preperation work done. He is polite and curtious and although it is an expensive do and I'm not too enthusiastic about being there.
I would rather spend the money on me and in his company the a greasy garage mechanic that can charge what he likes and give a poor service.

Davidboy

Toothsmith wrote:

£1000 for a crown is very top end. This is either a very up-market cosmetic practice, or your friend was not giving you the full story.

If the tooth was badly broken down, needed root filling, and re building prior to crowning, then £1000 is possibly the TOTAL bill. But that is a heck of a lot more work than just crowning a tooth.

It's a bit like saying a builder is going to charge me £100,000 to put a chimney on my roof without bothering to inform you that he has to build a house to put the chimney on in the first place!

I'm sure he would have been given alternatives. If a tooth needs that much work to 'crown' then having it out and replaced by a bridge is a realistic, and possibly cheaper alternative.

I appreciate that private dentistry is expensive, but that's how much it costs to run the service. I would love to provide a low cost service, but it ISN'T a low cost thing, so someone would have to subsidise it.

If the Government want to step in there and then call it NHS dentistry, that's fine by me, but they need to get their act together and produce a package that is workable. What we have at the moment is crumbling, and the thing that's going to replace it come April is so bad it's dead in the water already.

I'm not getting at you DavidBoy. Your concerns are valid, and your opinions are a lot more sensible then some I've had to deal with on these pages.

The bottom line though is that dentistry is a bespoke service. No two mouths, people or fillings are exactly the same, therefore there can be no 'mass market discount' for it.

Dental practices have to stand up as a business in this country, which means they have to have an income in excess of expenditure.

I think you are sort of agreeing with me, I am not getting at Dentists, I am just saying this government is not looking after it's people very well. In fact it is doing a very lousy job. The original questioner is asking whether it is the end of free dentisty for children. As I have already mentioned, it is not free, I have paid all my life NI contributions for my children to receive dental treatment, now no longer available for a lot of kids, this is so appalling, I do not know how the government can okay this. I have been lucky in the fact both my children are now grown up, but both have had dental treatment, braces etc., so am very grateful, but that does not stop me feeling very sorry for those kids who will not be able to receive the same treatment.

I am suffering other ways with this flippen government, I have one daughter at uni, the other starts this year with the £3000 fees. I earn too much to get any help, where are the likes of me going to get hundreds of pounds for dental treatment? I am sorry but this is all wrong. Blair time to go mate!

And yes sorry my mate had to have root filling redone, as well as a new crown, but even so £1000....crickey moses. I am soooo glad I still have a NHS dentist. Long may he continue.


D

Rikki

I think children should always be entitled to free dental care. If all parents had to pay I'm sure some parents out there would forsake their childrens teeth because of the cost. That is not fair on the children. They need to be encouraged to visit the dentists and look after their teeth. They will become the neglected part of the dental service.

Toothsmith

albertross wrote:

Are there any government limitations on the number of patients a practice can treat. I have been loyal to a practice for years, but unable to get to the surgery on weekdays due to out of town work commitments, and am slightly peeved that I've been dropped and am now bottom of a long waiting list. They won't even see me privately.

No - there are no limitations. That is one of the problems. A dentist can sign as many patients as he/she likes onto their books, and get a fair bit just from the NHS registration fees. The more patients on the books, the worse the service is going to be though.

You and your dentist have a different idea of loyalty! Just because it's the only dentist you've been to for the past X years, you consider yourself a 'loyal' patient. Your dentist considers a loyal patient to be one that attends and actually puts money into the practice!

If it is a mainly NHS practice, then they won't really have time to do 'private' stuff. hey will be too busy seeing their NHS patients. Extra hours are not created in the day at any price!

albertross wrote:

Why can't it work like any other service, you book an appointment when there is an available slot, if it is in 2 months time, that's fine by me, I just want a checkup. No other service I can think of says we don't want any more customers.. You haven't bought a new car in the last 15 months, so we are not interesting in selling you one.

2 months time is no use if you are in agony and have a face the size of a balloon!

Consider a list of x thousand patients. Even if only a small percentage have a filling fall out creating a sharp edge that's cutting the tongue, or an actual toothache, or a child that's been up all night, etc etc, then that's a fair few emergency appointments to squeeze in every day. Those squeezed in appointments mean that something else is going to have to be done a bit more quickly than the dentist would have liked, which means that in a couple of weeks, that patient may be back with a broken filling that's sharp!

You can see how the vicious circle develops?

Fraserca

Tooth - This article that you pointed to concerns a 4 year old with 4 rotten teeth causing abcesses. These didn't develop overnight - it was a failure to attend for regular checkups and basic oral hygiene that caused this. Now why did that happen ? Possibly because there was no NHS dentist available to offer the regular care needed.

I imagine that the cost of attending a private clinic was prohibitive for the family.

That is the point I was making - High cost private care, a failure of the NHS dentistry over wide areas of the country and a failure of both the profession and the Govt to sort this out results in children and others suffering long term damage.

Oh and BFG - I was referring to the high cost of non NHS treatment earlier. If you are going to scoff then at least read the postings. Thank you